Beeinflusst sportliche Aktivität die Revisionsrate nach Knietotalendoprothese? Analyse eines 12-Jahres-Follow-up

Abstract

Schlussfolgerung Es konnte gezeigt werden, dass 12 Jahre nach Primärimplantation einer KTEP die Revisionsrate in der Gruppe der sportlich aktiven Patienten verglichen mit den Inaktiven deutlich reduziert war. Daher lässt sich schlussfolgern, dass moderate sportliche Aktivität nach künstlichem Kniegelenkersatz keinen negativen Einfluss auf die Standzeit einer Knietotalendoprothese hat, sondern sogar möglicherweise zu verbesserter Osteointegration und damit zu weniger osteolytischen Reaktionen mit daraus resultierender aseptischer Prothesenlockerung führen könnte. ABSTR AC TBackground Total knee replacement is the only surgical op-

Understanding the impact of physical activity level and sports participation on implant integrity and failure in patients following unicompartmental and total knee arthroplasty: A scoping review

“…Third, studies with follow-up periods <5 years may not have had sufficient time to observe any potential negative impact of physical activity level or sports participation on implant integrity or failure. Furthermore, several potentially relevant articles were excluded due to language [ 59 ] and not having conducted analyses between relevant sub-groups (e.g. low vs. high physical activity) [ 50 , [59] , [60] , [61] , [62] , [63] ].…”

“…Furthermore, several potentially relevant articles were excluded due to language [ 59 ] and not having conducted analyses between relevant sub-groups (e.g. low vs. high physical activity) [ 50 , [59] , [60] , [61] , [62] , [63] ]. However, these excluded studies also support the notion that higher levels of physical activity [ 59 ] and participation in higher impact sports such as tennis [ 62 ] and downhill skiing [ 63 ] appear to be safe in the short-to mid-term following TKA.…”

Twenty-one sports activities are recommended by the European Knee Associates (EKA) six months after total knee arthroplasty

“…A significantly increased revision rate (all reasons) was found among physically active patients (3.2% vs. 1.6% for 5–10 years). Similarly, Valle et al retrospectively compared 88 athletic TKA patients and 42 inactive patients [19]. Twelve years postoperative, the revision rate was significantly higher among inactive patients (23.8% vs. 15.2%).…”

Recommendations for Patients with High Return to Sports Expectations after TKA Remain Controversial

“…This was in line with previous observations [24,25], where patient-reported outcomes suggest a correlation between preoperative levels of physical activity and RTS capacity after TKA. Most patients return to low-impact sports after TKA with popular activities such as bicycle riding, swimming, hiking, and sometimes skiing (alpine) [26][27][28][29][30]. Previous similar studies observed that most surgeons are rather reluctant to recommend participation in high-impact sports after TKA [31,32], leading concerns were aseptic loosening due to increased wear and debris [33,34].…”

“…Regarding high impact sports the responses were more controversial. Although available studies suggest that physical activity may negatively impact the longevity of the implant [26,33,34], other publications have proposed that at least moderate physical activity has no negative impact, instead, improving osteointegration and implant stability [36]. Indeed, higher wear rates have been observed in younger and more active patients [37].…”